Laura Mize, M.S.

, CCC-SLP
Pediatric Speech-Language Pathologist

A Parents Guide to Understanding

Speech-Language
Development in
Toddlers

Language development does not happen overnight.

Im going to give you an overview of how basic

communication skills evolve so that youll have a better
understanding of this process and will be able to gauge
how your child is doing. However, this material should
not be a substitute for advice from a certified speechlanguage pathologist who can work individually with
you and your child.

Laura Mize, M.S., CCC-SLP

Table of Contents
Introduction
Chapter 1 Interacting
Chapter 2 Understanding
Chapter 3 Expressing
Chapter 4 How a Child Sounds
Conclusion
Communication Milestones Chart

Resources from teachmetotalk.com

INTRODUCTION
The process of developing language
begins long before
you hear a childs first word!

Late Talking
Should I worry?
No two children develop alike.
Dont compare your child to someone elses child.
For the most part, thats wise advice, but there is something important that
you should know
There are patterns of communication skills that babies and toddlers acquire
within broader age ranges. If skills are not emerging and developing within
that time frame, we know that a toddler may have a speech-language delay
or disorder.
Whats the risk?
When communication delays are left untreated in early childhood,
research tells us that the risk increases exponentially for
future academic and learning issues.
Learning to use and understand language is essential for nearly every other
kind of learning your child needs - not only as a toddler, but as he gets older
and enters preschool and kindergarten.

No one knows your own child

like you do.

You are the EXPERT!

However, sometimes a parent can be so wrapped up in
celebrating all of the things that are so wonderful about that
child that they overlook areas where the child may be
struggling.
That is why it is SO important, as were talking about language
development, for you to objectively look at your child and
identify specific areas where he may need help.
As we proceed through each of these areas of communication
skill development, well also review a list of red flags which
should indicate to you - in no uncertain terms - if there is a
problem with your childs language development.
Even if you do realize that there is an issue with the way your
child is learning to communicate, the good news is

Parents play a key role

in providing early
intervention. This
doesnt necessarily
mean youll see a
professional right
away. What it WILL
mean is that, as a
parent, you can change
what youre doing at
home to help your
child.

Early intervention works!

Communication
Four Important Areas
Early speech-language skills unfold in a predictable
pattern and include how a child learns to:
INTERACT with others
UNDERSTAND what words mean
EXPRESS intentions with gestures or words
PRODUCE speech sounds others can understand

A problem in any one of these areas can result in

speech-language delay or disorder.
Knowing what to pinpoint as the source of the problem
determines how we work with a child and, ultimately,
the progress he or she will make. To put it simply:
If youre working on the wrong problem,
youre likely to see little, slow, or no success.

CHAPTER ONE
How A Child Interacts

Social Interaction
Building the Foundation
All communication begins with interaction between
two people.
Until a child learns to:
pay attention to people
listen to what others say
initiate contact with other people
enjoy playing together and sharing experiences
.hes not ready to understand and use words.

Social skills are the foundation for language.

Interacting is Connecting
What We Want to See
Seeking out and responding to other people is a skill we want
to see develop in infancy. We want to see babies:
enjoy watching other people particularly their faces.
smile, laugh, and get excited when you talk to him by the
time hes 6 months old.
Even though theyre busy by nature, toddlers with typically
developing language skills are not difficult to engage. Toddlers
should:
include you in their activities.
show you things.
try to direct your attention to look at them.
look back and forth between you and a toy as you play
together.
smile at you with frequent and easy eye contact.
If your child is doing these things, her social skills are
developing nicely and not a factor in late talking.

Red Flags
with Interacting Skills

Difficulty making and maintaining eye contact

Doesnt use eye gaze to get your attention
Seems to ignore other people
Doesnt consistently respond to his name by 12 months
Difficulty getting her attention when you talk to her
Doesnt look to where youre pointing or when you say to
her, Look!
Demonstrates better attention to objects, a DVD or TV
show, or an app or iPad than to people and conversations
No back-and-forth sharing of sounds, smiles, or facial
expressions
Seems very independent and doesnt know how to ask for
help when she needs something
May not initiate or respond to cuddling

If a child exhibits several red flags with

interaction skills, the issue is likely
more serious than late talking.

What You Can Do

To Improve Interaction
Get down on her level on the floor and really play together.
Find things she likes to do with you and do them over and
over.
Encourage him to look at you and to share experiences with
you. If hes playing with a toy or watching his favorite DVD,
make sure youre included too!
As you play together, you should also focus on helping him
learn to copy or repeat what you do. Teach him to imitate you
with toys or during little games that you know hes learning
from you. Try "Patty Cake or Ring Around the Rosies.
Limit screen time. Research says toddlers who watch more
than 2 hours a day with screens are at risk for delays.
The worst thing you can do for a child who is struggling to
learn language is to let her check out, do her own thing, or
remain disconnected from others for much of the day.
Sing! Play! Tickle! Run! Jump! Be silly! Have fun together!

Did you notice

my eyes in this
picture? Make
yourself
interesting to
look at so that a
child will learn
to include you
as you play
together.

A child must learn to love

to stay with you and play with you
before he can learn
anything else from you!

CHAPTER TWO
How A Child Understands

Understanding Skills
Cognition and Receptive Language
During the first year a baby learns to understand how the world
around him works. He learns about routines and when to
expect things to happen in his day. She learns that objects dont
disappear even though she cant see them (object permanence)
and that she can make things happen (cause & effect). When a
child becomes more skilled at moving his own body, he learns
that he can get things and make things better for himself
(simple problem solving). These kinds of milestones are
cognitive or thinking and learning skills.
A childs cognitive skills blossom into an amazing ability to
understand what people are saying to him. Between 12 to 18
months, a child makes associations with words and begins to
follow directions. This is referred to as receptive language or
auditory comprehension.
Receptive language and cognition are important because until a
child learns to understand words, she is not ready to use those
words to communicate.

A child must understand words

BEFORE he begins to say words.

When Learning is Difficult

Diagnoses that Affect Cognition
If your child was born with a condition that affected his or her
brain development in any way during pregnancy, we know this
can impact cognition, or how a child learns. This may include
children with:

genetic differences like Down syndrome, Fragile X or other

genetic medical diagnoses
neurological problems that cause motor delays or muscle
tone differences such as cerebral palsy, hypotonia or
hypertonia
other issues due to complications during pregnancy or
prematurity

Sometimes this isnt explained clearly enough to parents. If

youre in this situation, I want to be sure you understand that
you should expect for your child to have some difficulties
learning to understand words and then to talk.

There will also be children who have no known diagnosis at birth

or as babies who also begin to show, even as early as twelve
months old, that they are having difficulty learning to
understand what words mean.

Red Flags

for Cognitive & Receptive

Language Delays

Not looking when you call their names by the first birthday
Doesnt pick up on other peoples facial expressions, tone
of voice, and gestures by 12 months
Doesnt follow simple directions by 18 months
Doesnt look at and point to familiar people, objects, and
body parts when asked Wheres ____? by 18 months
Doesnt point to familiar pictures in books by 24 months
Repeats a question rather than answering it
Answers a question incorrectly or offtarget
Uses the same words and phrases without adding many
new ones
Most speech is jargon or jabbering or using mostly
unintelligible sentences after 2 (without the presence of a
growing single word vocabulary)
A childs ability to understand and respond to language is a
factor which helps us determine if a child has a more
significant developmental issue or is just a late talker.

If a child exhibits red flags with cognition or receptive

language, the issue is more serious than late talking.

What You Can Do

To Improve Understanding
Simplify what you say to your child. Speak in single words and
short phrases.
Talk about what she is paying attention to in the moment.
Give him opportunities to demonstrate that he understands.
Ask him to follow requests throughout the day such as, Show
me the ____, and Wheres the _______? If hes not
pointing yet, encourage him to look around to find what
youve asked him to locate.
If a child does not seem to understand, show her what to do. If
youve said, Give me your doll, and she doesnt move toward
the doll, point to direct her attention.
You may have to provide physical assistance to help a child
learn to follow directions.

As you begin to work at home with your child, it is

more important for your child to understand what a
word means than it is for him to say the word.

Teaching a child to
understand words
doesnt have to be
boring. Look at how
my little friends are
following new
commands such as,
Put the puzzle
pieces on your
head! Being silly can
motivate a child (or
two!) to stay with
you and learn as you
play together.

Adults may think a child is being bad or

disobedient when he doesnt seem to
listen or follow directions.
The real problem may be that
he doesnt understand language.

CHAPTER THREE
How A Child Expresses
What She Thinks and Needs

Expressive Skills
More Than Talking!
Before we hear words from a child, we always see other kinds
of communicative intent emerge first. Communicative
intent means that you can see that a child is trying to
communicate with you or tell you something. Toddlers first
begin to do this by crying intentionally or whining, then they
advance to vocalizing purposefully, often by grunting or using
single syllables that sound like commands, such as Da!
Toddlers who are moving along with expressive language will
begin to use purposeful gestures, like reaching for you or
trying to direct your actions. Those kinds of body movements
turn into real gestures that we recognize as communicative,
such as waving bye-bye, blowing a kiss or pointing to get you
to look at something they see. All of these gestures begin
around the age of twelve months, when a child learns to
imitate your actions.

Gestures are an important predictor for language.

Typically, gestures emerge just before true words!

Red Flags
for Expressive Delays

No babbling by 12 months
No back-and-forth gestures such as pointing, showing, reaching, or
waving by 12 months
No consistent imitation of actions, sounds, and words by 15 months
No words by 16 months
Less than 50 words at 24 months
No two-word phrases without imitating or repeating by 24 months
No back-and-forth conversational turn-taking by 30 months
Any loss of speech, babbling, or interaction skills at any age

If your child is over two and is still not talking or only says a
handful of words, there is an expressive language delay.
Please dont listen to misguided advice and do nothing. At
the very least, youll need to change what you do at home to
help your child begin to talk.

If a child is developing slowly during a time when other peers

are rapidly progressing, the child will be falling further and
further behindand no parent wants to see that!

The older a child is at the time when intervention

begins, the less positive the outcome.

What You Can Do

To Help at Home
Teach a child to imitate actions during play. Little games like
Give Me 5 or songs with hand motions like If Youre Happy
and You Know It are critical first steps to helping a child learn
to talk. He needs to begin to do his part during the game.

Introducing simple sign language is a life saver for many

families and toddlers! Try signs for things he loves or requests
like more and please.
Many times single words are too difficult for late talkers. Try
FUN play sounds like animal and car noises and encourage her
to repeat those silly sounds after you as you play together.
Simplify what you say to your child so that your child can
imitate words. Speak in mostly single, familiar words when
youre trying to encourage him to repeat you.
Focus on words your child needs to say to get what she wants
like words for toys, food and events. Words for colors, shapes,
numbers, and letters arent important for late talkers!

Children dont need to just learn to talk, they need to

know what those words mean and use those words to
communicate with others.

Toddlers arent
nonverbal because
theyre stubborn or
lazy. Late talking is a
true developmental
delay or disorder that
may require speech
therapy. Waiting to get
help is the worst
mistake many parents
of late talkers feel they
made.

Its not that a child WONT talk,

often its that he CANT talk!

CHAPTER FOUR
How A Child Sounds

Intelligibility
Not Necessarily Adult Sounding Speech
Most toddlers substitute sounds and simplify words as they
learn to talk. Many children will continue to substitute laterdeveloping consonant sounds (r, l, th) until theyre 6 or 7.
Even when a childs speech contains some sound errors, a
parent should understand at least half of what a 2 year-old
says and nearly all of what a 3 year-old says. We do not expect
unfamiliar adults to understand 100% of what a child says until
hes 5. Even then there may be some sound substitutions.
Children with muscle tone differences that have impacted
their feeding skills will also have difficulty being understood
when they are learning to talk.
CAUTION: When a child talks in what a parent might call his
own language or uses long strings of unintelligible speech,
this is jargon. Jargon is a part of normal expressive
development, but when jargon persists past age 2 and the
child is not using very many single words you do understand,
this is usually a problem related to language development
rather than how a child pronounces words.

What toddlers try to say is much more important

than how they actually say it!

Red Flags
For Speech Development
Even though we do not expect that everyone would
understand 100% of what a child says until hes older, there
are characteristics, even before age three, that tell us that a
child may have a significant speech sound delay or disorder.

Limited consonant sounds in childs speech

Vowel sounds are substituted or left off in words
Beginning consonant sounds are omitted
No two-syllable words are used
Parents dont understand at least half of what a child says
at age 2 and most of what a child says by age 3

If no one understands the child, even his or her parents, thats

extremely frustrating for everyone especially for the child!

Ignoring a significant speech intelligibility problem

can set a child up for frustration and failure.

What You Can Do

To Help at Home
Avoid overcorrecting a new talkers word attempts. Focus on
the intent of the childs message.
Dont repeat a childs errors back to them. If a child says, uh
for cup, say, Cup! Heres your cup! Many toddlers need
practice hearing words produced correctly before they
recognize an error in their own speech.
Practice a new sound alone only a few times, then quickly
move the new sound to a word.
Some toddlers will respond and correct their mistakes when
you ask them to repeat words as you slowly model the correct
way to pronounce words. Toddlers with developmental delays
may not be able to do this until after age 3.
Negative attention and overemphasizing speech sounds may
stall progress in toddlers who are new communicators.
Focus on talking and communicating rather than
perfect speech with late talkers!

Dont target speech

intelligibility as the
primary focus for
therapy until a childs
language skills are
close to an ageappropriate level.
We always want to
prioritize, recognize,
and reinforce overall
communication skills
in late talking toddlers.
Accuracy with speech
sounds should be our
least important goal
for children under 3.

At this age, what a child says is much

more important than how he says it.

CONCLUSION
Remember that you are your
childs first and best teacher!

Parents make a HUGE difference

in how every child learns to
communicate. Even when there are
significant concerns, taking action at
home is a key factor in progress.

Milestones
Communication Skills
Here's a nice, short checklist adapted from Babytalk. Quick
remindermilestones aren't an "average" age. This list, like other
milestone checklists, notes when MOST babies in the age range
(around 90%) have mastered the skill. While a child who is not doing
these things isnt officially behind, there is cause for concern. The skills
listed here are the end of the age range for typical development noted
with the word "By __ months." Be sure you're interpreting this
important information correctly!

By 3 months: Your baby should smile socially, smile to voices, watch

faces intently, coo, and make other noises.
By 6 months: Your baby should recognize you and seem happy to
see you, seem interested in different sights and sounds, and begin
to babble.
By 9 months: He should engage in back-and-forth interactions with
smiles, facial expressions, and sounds and respond to his name.
By 12 months: Your baby should point to and reach for things,
wave, and say one word purposefully in addition to mama and
dada.
By 18 months: She should say 10 to 26 single words, point to
objects that interest her, and bring things to show you.
By 24 months: Your toddler should say at least 50 words and use
two-word phrases on his own like Bye-bye mama and Car mine.

Best Resources
teachmetotalk.com
GREAT PLACE TO START FOR ALL PARENTS:
Teach Me To Talk the DVD Learn 6 simple techniques parents can use
at home for success with late talkers. See play-based speech therapy
with toddlers in real therapy sessions. Easy & effective!

Additional Recommendations Specific To Your Own Childs Needs

To Work on Interacting Skills:
Teach Me To Play WITH You EXCELLENT step-by-step activities in a 190
page manual for teaching a toddler to consistently connect with you
during fun social games, songs, and simple play using familiar toys.
To Work on Understanding Skills:
Teach Me To Listen and Obey 1 & 2 2 DVD set for helping children
with receptive delays learn to understand what words mean and follow
directions. Bonus section with disciplinary techniques recommended
for toddlers who have difficulty understanding language and rules.
To Work on Expressive Skills:
Building Verbal Imitation in Toddlers 180 page book outlines the
recommended treatment approach for late talkers organized in 8 levels
with specific instructions, word lists, and activities with toys and daily
routines. Perfect choice for parents as well as therapists who work with
toddlers and want written how to directions. Simple & successful!
To Work on How a Child Sounds:
Teach Me To Talk with Apraxia and Phonological Disorder 2 DVD set
for parents of toddlers diagnosed with speech sound delay/disorders.

teachmetotalk.com
will help you help your child!
Enter the coupon code SAVE15 for 15% off your initial order for DVDs and books!
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Laura Mize, M.S., CCC-SLP